title: Determinants of the desire to institutionalize in Alzheimer's caregivers.
abstract: BACKGROUND
  The desire to institutionalize is an important predictor of future institutionalization. Few studies have examined potentially modifiable caregiver characteristics which might be the focus of future interventional strategies.
  
  
  METHODS
  A total of 102 patient/caregiver dyads with Alzheimer's disease (n = 84) or mild cognitive impairment were recruited through a memory clinic. Cross-sectional analyses of a range of patients, caregivers, and context of care-related characteristics were conducted.
  
  
  RESULTS
  Caregiver desire to institutionalize was significantly associated with a number of potentially modifiable variables including caregiver coping style, self-efficacy, depression, burden, and the presence of an unmet service need. In a multivariate analysis, caregiver burden, depression, and nonspousal status were the only significant independent predictors of caregiver desire to institutionalize in a model which correctly classified 80.4% of caregivers.
  
  
  CONCLUSIONS
  Interventions which seek to reduce caregiver desire to institutionalize should adopt a multifactorial approach to reduce symptoms of burden and depression in caregivers.
authors.affiliation: Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland. gallagherdamien@hotmail.com
authors.forename: Damien
authors.initials: D
authors.lastname: Gallagher
authors.forename: Aine
authors.initials: A
authors.lastname: Ni Mhaolain
authors.forename: Lisa
authors.initials: L
authors.lastname: Crosby
authors.forename: Deirdre
authors.initials: D
authors.lastname: Ryan
authors.forename: Loretto
authors.initials: L
authors.lastname: Lacey
authors.forename: Robert F
authors.initials: RF
authors.lastname: Coen
authors.forename: Cathal
authors.initials: C
authors.lastname: Walsh
authors.forename: Davis
authors.initials: D
authors.lastname: Coakley
authors.forename: J Bernard
authors.initials: JB
authors.lastname: Walsh
authors.forename: Conal
authors.initials: C
authors.lastname: Cunningham
authors.forename: Brian A
authors.initials: BA
authors.lastname: Lawlor
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000523:psychology / Q000628:therapy; D017281:Cost of Illness; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007326:Institutionalization; D007494:Ireland; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D020377:Self Efficacy; D012847:Single Person / Q000523:psychology